Chapter 52, Concepts of Care for Patients With Inflammatory Intestinal Disorders

"Consume a low-fiber diet while your diverticulitis is active. When inflammation resolves, consume a high-fiber diet."

Which instruction would the nurse give a patient when teaching about dietary methods to help manage exacerbations of diverticulitis?

Instruct the patient to take monthly vitamin B12 injections, Teach the patient about drug therapy and the side effects, Teach the patient about the usual course of the disease and symptoms

Which instruction would the nurse give to a patient with Crohn disease to manage the condition? Select all that apply. One, some, or all responses may be correct.

Tell the patient to apply a thin coat of a protective barrier cream

Which instruction would the nurse give to a patient with inflammatory bowel disease with diarrhea regarding skin care?

Be aware of the symptoms of toxic megacolon that we discussed.

Which instruction would the nurse include in the discharge plan for a female patient diagnosed with ulcerative colitis (UC) who is going home on loperamide for symptomatic management of diarrhea?

High-protein meals

Which kind of diet would be provided to a patient to promote the healing of a fistula?

Increased C-reactive protein, Decreased potassium levels

Which laboratory finding is consistent with ulcerative colitis (UC)? Select all that apply. One, some, or all responses may be correct.

Vedolizumab

Which medication prevents the migration of white blood cells (WBCs) to inflamed bowel tissue?

Glucocorticoids

Which medication would a patient with ulcerative colitis who complains of severe diarrhea with exacerbations be taught to take for flare-ups?

Metronidazole

Which medication would be helpful in a patient who has a fistula associated with Crohn disease?

Sulfasalazine

Which medication would be used as the first-line treatment for mild ulcerative colitis?

Providing adequate nutrition and fluid and electrolytes

Which nursing action is the highest priority for a patient with Crohn disease who has developed a fistula between the bowel and bladder?

Restricting lactose-containing foods

Which nursing action would help minimize a patient's discomfort when experiencing an exacerbation of ulcerative colitis (UC)?

"Report any cognitive, motor, and sensory changes immediately to your health care provider.

The primary health care provider prescribes natalizumab to a patient with Crohn disease (CD). Which instruction is important to teach the patient before beginning this medication?

Severe

A patient reports having seven to nine bloody stools per day. The nurse finds that the patient has fever, tachycardia, anemia, and abdominal pain. The patient's laboratory reports indicate elevated C-reactive protein. Which classification of ulcerative colitis (UC) do these findings support?

Intolerance to milk, Exposure to antibiotics, Travel to a tropical area, Use of NSAIDs

A patient reports severe diarrhea and abdominal pain. Which information collected from the patient would indicate an increased risk for inflammatory bowel disease? Select all that apply. One, some, or all responses may be correct.

"It is usually ready to be closed in about 1 to 2 months."

A patient with ulcerative colitis (UC) has stage 1 of a restorative proctocolectomy with ileo pouch-anal anastomosis (RPC-IPAA) procedure performed. The patient asks the nurse, "How long do people with this procedure usually have a temporary ileostomy?" How would the nurse respond?

Corticosteroid therapy will be tapered.

A patient with ulcerative colitis (UC) is prescribed sulfasalazine and corticosteroid therapy. As the disease improves, which change would the nurse expect in the patient's medication regimen? 1 Sulfasalazine will be stopped.

Sulfasalazine

The nurse is teaching a patient with ulcerative colitis about different medication regimens. Which drug would the nurse explain has a complication of hemolytic anemia if taken in higher doses?

"Eventually, the amount and consistency of the stool will change."

A patient with a new ileostomy is distressed because of the large amount of green, liquid stool that must be emptied from the pouch several times each day. Which statement by the nurse to the patient is accurate?

A change in position may be what is needed for you to have intercourse with your wife.

A male patient with a long history of ulcerative colitis experienced massive bleeding and had emergency surgery for the creation of an ileostomy. He is very concerned that sexual intercourse with his wife will be impossible because of his new ileostomy pouch. How would the nurse respond?

Cardiac dysrhythmias

A pathology report indicates that a patient is infected with Trypanosoma cruzi and is diagnosed with chronic Chagas disease. Which finding would the nurse assess in this patient?

Moderate

A patient has been diagnosed with ulcerative colitis (UC) and reports having between four and five bloody stools per day. How would the nurse classify the intensity of this patient's UC?

"This medication is used to reduce intestinal inflammation.

A patient newly diagnosed with ulcerative colitis (UC) is started on sulfasalazine. Which explanation will the nurse give the patient about the reason for use of this drug?

Sulfasalazine

About which medication would the nurse teach a patient who is newly diagnosed with moderate ulcerative colitis (UC)?

Patient D

After assessing these four different patients with ulcerative colitis, which patient is likely to have a fulminant infection?

I should use skin sealants and ostomy skin creams as needed to prevent irritation

After the nurse teaches a patient about caring for an ileostomy at home, which statement by the patient indicates a correct understanding of the teaching?

Patient A

The nurse is reviewing the nutritional plans for four patients with inflammatory intestinal disorders. Which patient's nutritional plan indicates a need for further teaching?

Change the entire pouch system every 3 to 7 days.

The nurse is caring for a patient with ileo-anal pouch anastomosis who has undergone a restorative proctocolectomy. Which instruction given by the nurse regarding pouch care will provide effective treatment?

Vomiting, Anorexia, Headache

When teaching a patient who recently began taking sulfasalazine about the drug, which side effect would the nurse tell the patient is commonly associated with this medication and should be reported to the health care provider? Select all that apply. One, some, or all responses may be correct.

Steatorrhea, Abdominal pain, Diarrhea and/or constipation

Which classic symptom is seen in celiac disease? Select all that apply. One, some, or all responses may be correct.

Presence of blood and mucus in the stool

Which clinical findings in a patient indicate ulcerative colitis?

Abdominal pain

Which clinical manifestation is seen in Crohn disease?

Fistula

Which complication is associated with Crohn disease?

Colorectal cancer

Which complication is seen exclusively in patients with ulcerative colitis?

"Call the health care provider if your stoma has a bluish or pale look."

Which information would be most important to include when teaching a patient about caring for a new ileostomy?

"Refrain from drinking alcohol., Refrain from physical activities like bending

Which instruction given by the nurse will be beneficial to an older-adult patient with diverticulitis? Select all that apply. One, some, or all responses may be correct.

Avoid large crowds and anyone who is sick.

Which instruction would the nurse emphasize when teaching a patient with Crohn disease about managing the disease with the drug adalimumab?

"Lactose-containing foods should be reduced or eliminated from your diet.

Which instruction would the nurse give a patient newly diagnosed with ulcerative colitis (UC) about diet and lifestyle choices?

Weight loss, Skin in the perianal area, Physical and emotional rest, Color, volume, and consistency of stools

Which parameter would be monitored in a patient with chronic inflammatory bowel disease? Select all that apply. One, some, or all responses may be correct.

The patient with diabetes mellitus type I

Which patient is at risk for celiac disease?

The patient with Crohn disease

Which patient requires infliximab treatment?

Leukocytosis

Which physiological change is seen in a patient with ulcerative colitis?

Stool volume decreases and becomes thick.

Which physiological changes take place in a patient after about a week after having a total proctocolectomy with a permanent ileostomy?

Fistulas, Osteoporosis, Malabsorption, Abscess formation

Which potential complication is associated with Crohn disease? Select all that apply. One, some, or all responses may be correct.

"Were you on antibiotic treatments in the past 3 months?

Which question would the nurse ask while assessing a patient with ulcerative colitis (UC)?

Patients with UC may experience hemorrhage

Which statement correctly differentiates Crohn disease (CD) from ulcerative colitis (UC)?

Chronic diarrhea, abdominal pain, and fever

Which symptom is most indicative of Crohn disease (CD)?

Enterovesical fistula

Which term is used to describe a fistula that is present between the bowel and the bladder?